Immunoelectrophoretic analysis of subretinal fluid and its diagnostic significance. (1) Immunochemical examination shows that subretinal fluid can be divided into two major categories. A 'barrier pattern' is found in the presence of an effective blood-retinal barrier, whereas a 'barrier-damage pattern' emerges when there is a progressive increase in the permeability of the choriocapillarispigment epithelium complex. (2) The immunoelectrophoretic appearance of the subretinal fluid from a recent simple detachment shows a 'barrier pattern' and consists of only low molecular-size plasma proteins, since the choriocapillaris-pigment epithelium complex allows the smaller proteins to escape into the subretinal space more readily than the larger. There is, therefore, a general relationship between the clearance of any plasma protein in the subretinal space and its molecular size.(3) It is only in long-standing detachment that the permeability of the blood-retinal barrier is sufficiently altered to allow the passage of higher-molecular-weight proteins such as IgG and IgA. Increase in permeability of the choriocapillaris-pigment epithelium complex, due possibly to structural modifications, is responsible for the 'barrier-damage' pattern of the subretinal fluid. (4) There may be variations in the degree of barrier breakdown. In those retaining a highly selective barrier, little or no high-molecular-weight proteins escape in the subretinal fluid even in cases of long-standing detachment, whereas, in those with low selectivity, the leakage of high-molecular-weight proteins parallels that of the smaller proteins. (5) The apperance of very large molecules in the subretinal fluid indicates a preceding choroidal inflammation or neoplastic invasion; and the detection of IgM is, therefore, of value in the differential diagnosis of retinal detachment.


Choice of the proper procedure in the surgical treatment of glaucoma.


Ocular aspects of internal carotid stenosis. Because extracranial atheromatous disease of the carotid arterial system is a common cause of 'stroke', ophthalmologists may be the first to see patients at risk who present with early signs of this condition. I. The history of previous observations of these signs and the anatomy and physiology of the structures involved are described. The physical and subjective signs and the significance of transient ischaemic attacks are discussed. Methods of diagnosis are reviewed with special reference to ophthalmodynamometry. II. A series of patients personally investigated and treated is analysed: (1)Endarterectomy was performed in seventy cases of internal carotid artery stenosis during a 15-year period (1959-73). (2) 36 cases from the years 1970-73 were studied in detail. (3) 50 per cent. of these presented with ocular symptoms, which were the only complaint in 22 per cent. (4) 95 per cent. of all patients with ocular symptoms experienced recurrent transient visual loss. (5) 61 per cent. of all patients with ocular symptoms showed significant fundus changes. (6) ODM enabled the haemodynamics of the carotid arterial systems to be evaluated in 79 per cent. of the patients studied. (7) The results of surgery suggest that patients who present with ocular symptoms have a better prognosis than those who present with neurological symptoms only.


Multifocal choroiditis.

Multifocal choroiditis.


The elderly aphakic and the use of the iris-clip lens.


Senile changes in visual acuity.

Senile changes in visual acuity.


Management of the senile cataract.

Management of the senile cataract.


Drusen of the optic disc. A histopathological study. A retrospective study of autopsy and surgically enucleated eyes yielded eighteen autopsy and four surgically enucleated eyes harbouring drusen of the optic disc. The average age of the patients in this series was 58-6 years. Various histopathological changes were noted in the optic nerve head and adjacent retina; these comprised compression of nerve fibres, partial optic atrophy, elevation of the optic disc, cytoid bodies, disc haemorrhage, sequelae of haemorrhage, and juxtapapillary retinal scarring. All optic disc drusen were calcified and five of the ten disc drusen stained positively for the presence of iron.


Fundus changes immediately after cataract extraction. The effect of acute ocular hypotony as a factor in the formation of serous choridal detachments was investigated in 45 eyes undergoing cataract extraction. A fundus examination was made with binocular indirect ophthalmoscopy immediately after lens removal and in the early postoperative period. No choroidal detachments occurred, either early or late. Full-thickness infoldings of the eye wall in the posterior segment were seen in 80 per cent of the eyes immediately after lens extraction. The orientation of these folds is described, and factors leading to their formation are discussed.


Analysis of senile changes in the palpebral fissure. This work was carried out to determine the changes in conformity and physiological movements of the eyelids with advancing age. Some conceptions fostered in the literature are false and should be discarded. Others have been corroborated. We concluded that the whole lateral canthus becomes lax and drifts medially with age. Therefore, surgical correction should aim at restoring the fixation of the lateral canthus to the youthful position.


Cystoid macular oedema in aphakia.

Cystoid macular oedema in aphakia.


Soft contact lens treatment of bullous keratopathy.


Ophthalmological results of a geriatric assessment survey.


Pilocarpine delivery by hydrophilic lens in the management of acute glaucoma. Patients with acute closed-angle glaucoma were treated with a hydrophilic contact lens saturated in 1, 4, or 8 per cent. pilocarpine or bt intensive 4 per cent. pilocarpine drops. The greatest hypotensive response was produced by the 1 per cent. presoaked lens and increased strength of soaking solution gave reduced response. Intensive drops gave the least response. In vitro studies show that the lens is effectively saturated after 2 hrs' soaking holds c. 700 mug. pilocarpine and yields almost all of the contained pilocarpine after 2 hrs' elution. The method of lens preparation is described and pharmaceutical studies confirm a shelf life of 4 months in a domestic refrigerator.


New apparatus for measuring forces in strabismus. An apparatus for measuring muscle forces in strabismus has been developed. The globe is fixed with a modified suction cup, force applied is measured by strain gauges, and the excursion of the globe is measured by a light pointer and tangent screen. The values of force generation tests for normal horizontal rectus muscles performing 30 degrees saccades lie mainly within the range of 60 to 80 G.


Ocular embolism.

Ocular embolism.


Retinal opacification after blunt non-perforating concussional injuries to the globe. A clinical and retinal fluorescein angiographic study. Fluorescein angiographic studies are reported on fifteen patients presenting with retinal opacification after blunt mechanical non-perforating injuries involving the eye. In patients who subsequently regained full visual function and in whom complete resolution of the retinal changes occurred, retinal fluorography carried out less than 24 hours after injury revealed no abnormal features. In cases with more prolonged visual disability, retinal fluorescein examinations may, however, reveal damage to the retinal pigment epithelium before this becomes apparent  on routine ophthalmoscopy, or the existence of impaired perfusion through the retinal vessels. It is suggested, therefore, that retinal fluorescein angiography has a role in assessing the visual prognosis in patients presenting with traumatic retinal oedema.


Isolation of amoebae from eye infections in England. The laboratory investigations are presented on the first two recorded cases in England of infection of the eye by free-living amoebae. The distribution and pathogenicity of these amoebae are briefly discussed and some therapeutic possibilities derived from subsequent in vitro studies.


Acanthamoeba polyphaga keratitis and Acenthamoeba uveitis associated with fatal meningoencephalitis.


New techniques in the investigation of the orbit.


Essential blepharospasm.

Essential blepharospasm.


Social and other aspects of adjustment to single eye cataract extraction in elderly patients.


Filamentary keratitis.

Filamentary keratitis. Evidence is offered to support a hypothesis that filaments are composed of mucus with epithelial squames, lipid, and foreign matter taken up secondarily. The condition results when mucus excess is present with receptor sites on the cornea. Treatment should be directed at the receptor sites, the mucus excess, or the underlying conditions responsible for the two components.


Doyne Memorial Lecture, 1975. Correlation of optic nerve and visual field defects in simple glaucoma.


Prognosis and therapy of angioid streaks.


Drug interactions in ophthalmology.

Drug interactions in ophthalmology.


Vascular pathophysiology of the ocular postural response. A pneumatonometric study. The technique of pneumatic tonometry has been used to study new aspects of the response of the intraocular pressure to change of body position. The pneumatonographic procedure permits the intraocular pressure to be recoorded independent of body position. A modification of the procedure is described for the measurement of the ophthalmic arterial pressure and for the analysis of the change in intraocular pulse with increased intraocular pressure. The magnitude and symmetry of the postural response in normal healthy individuals have been found to contrast with the magnitude, stability, and asymmetry of the postural response in patients with ocular and arterial occlusive diseases. The abnormality of the postural response in a patient with severe occlusive disease is shown to parallel asymmetric and low ophthalmic arterial pressures.


The changing pattern of injury.

The changing pattern of injury.


Incidence of trauma to the eyes of car occupants.


Visual loss due to posterior segment disease in scleritis. Exudative retinal detachment and oedema of the posterior retina are well-recognized clinical entities for which a cause is rarely found. Scleritis may cause both these clinical syndromes by a spread of inflammation from the sclera into the uveal tract. Although treatment may result in a rapid resolution of scleritis, retinal detachment and macular oedema persist and prove extremely resistant, even to high doses of systemic steroids. Recovery may be incomplete and may occur only after weeks or months of treatment.


Electrodiagnosis and ultrasonography in the assessment of recent major trauma. This paper reports a prospective study of 47 eyes with opaque media after recent major ocular trauma which were assessed by measurement of visual acuity, electroretinography, visually evoked response, and ultrasonography. The results of each method of assessment were analysed as indiced of prognosis for visual recovery. Each method of examination proved of value for prognosis, and a combined assessment using all the methods together was of special value.


Pathological changes after trauma.

Pathological changes after trauma.


Electrophysiological and pathological investigation of concussional injury. An Experimental study.


Secondary reconstruction.

Secondary reconstruction.


Perforating injuries involving the posterior segment.


Portable trial lens carrier and self-illuminating test type cabinet.


Pregnancy in diabetic women: review of five years' experience at the Sacramento Medical Center.


Disposition of high school athletic injuries.


Multicentre trial of xenon-arc photocoagulation in the treatment of diabetic retinopathy. A Randomized controlled study. Interim report. An interim analysis of the cases in the British Multicentre Photocoagulation Trial shows that treated eyes with maculopathy retain better visual acuity than untreated eyes. The difference of the change in the mean visual acuities of the treated and untreated eyes is small but statistically significant. In those with new vessels as the predominant feature, there is a trend for treated eyes to have better visual acuity than untreated eyes, but the difference in the mean visual acuity of the two groups is not statistically significant.


Use and abuse of antimicrobial agents. (A critique).


Antimicrobial usage in patients with renal impairment.


Complication of antimicrobial therapy. (An overview).


Treatment of common infectious disorders.


[Significance of arterial blood gas analysis in the diagnosis and evaluation of the pulmonary function].


Fibrinolysis in the lung. Experimental studies on tissue localization and on the response to drug induced antifibrinolysis and to trauma.


Presidential address of the twenty-third annual scientific meeting of the American Society of Cytology.


Letter: An unusual artefact found in cytologic preparations.


Quality control in the cytology laboratory.


Fine needle aspiration biopsy in the evaluation of tumor-like lesions of bone. A consecutive series of bone lesions suspected to be tumors and examined by fine needle aspiration biopsy at the University Hospital Cytology Laboratory in Lund, Sweden, is reported. From 1966 to November 1974, 150 cases were examined. In 123, sufficient cellular material was obtained through aspiration by a needle with an outer diameter of 0.8 mm. The method is described. The reliability of cytology is compared with the results of the definite pathology after open biopsy or extirpation of the lesion. In the series of primary benign lesions 28 out of 39 were correctly diagnosed; among primary malignant 27 out of 38 were correct and among metastases 57 out of 73 were correctly diagnosed including those  where insufficient cellular material was aspirated. In cases where sufficient material was achieved the reliability of the cytological diagnosis was around 90 per cent. There was one false positive and two false negative reports of malignancy. Fine needle aspiration biopsy with cytology is recommended as a standard step in orthopedic oncological examinations. It has at least the same degree of diagnostic reliability as other diagnostic methods, such as X-ray, for instance; however, it does not replace open biopsy and histology when mutilating surgery is in question.


Influence of blood collection on incidence of 2,7-FAA induced rat leukemia. The oral administration of N, N'-2,7-fluorenylenebisacetamide induced leukemia, especially mature granulocytic leukemia, in rats. The peripheral blood was examined on various schedules, once or twice a week for a long term. The blood volume lost by a blood collection was little, but it was not negligible in small animals such as rats when the loss was repeated. We investigated the relationship between the volume of blood loss and the incidence of leukemia. The incidence of leukemia rose as the volume of blood loss increased. There was a positive correlation between them. The induction of mature granulocytic leukemia was thought to be increased by the promotion of the granulopoiesis which had been suppressed by 2,7-FAA. It was concluded that the blood loss by repeated blood collection for examination raised the incidence of 2,7-FAA induced leukemia.


Reliability of cytologic typing of lung cancer. In a prospective study of 111 cases of lung cancer, cytopathologic diagnoses were compared with histologic diagnoses. In 77.5 per cent of the cases, histopathologic diagnoses were in concurrence with cytopathologic diagnoses. The discrepancies occurred mainly in poorly differentiated adeno and  epidermoid carcinoma. Well differentiated adeno and epidermoid carcinoma were cell typed with 100 per cent accuracy and small cell carcinoma with 90 per cent accuracy.


Rapid lysis of vaccinia virus on neutral sucrose gradients with release of intact DNA.


Use of free fat transplants to prevent epidural scar formation. An experimental study.


Neurotoxicity of hydroxylated tryptamines: structure-activity relationships. 2. In vitro studies on monoamine uptake inhibition and uptake impairment.


Neurotoxicity of hydroxylated tryptamines: structure-activity relationships. 1. Long-term effects on monoamine content and fluorescence morphology of central monoamine neurons.


Letter: Detached ciliary tufts in cervico-vaginal smears.


Mesothelial papilloma: a case of mistaken identity in a pericardial effusion.


Involvement of alpha-adrenergic receptors at different levels of the central nervous system in the regulation of blood pressure and heart frequency.


Cytohormonal and histomorphologic patterns in endometrium in symptomatic premenopausal women. Endometrial histology in the premenopausal symptomatic group revealed hyperplastic endometrium in 29.1 percent of the cases. Cytohormonal evaluation has shown hyperesterin activity reflected by a high Karyopyknotic Index in cystic glandular and adenomatous hyperplasia. A fairly good positive correlation is seen between colpocytology and endometrial histology. In few patients vaginal cytology has revealed regressive activity which was not evident on histology alone. It is felt that cases showing regressive smears are the ones where treatment including estrogens should be most effective.


Acute myeloid leukemia appearing in two patients after prolonged continuous chlorambucil treatment for Wegener's granulomatosis. Two patients with Wegener's granulomatosis have been treated with chlorambucil and prednisolone continuosly for 3 and 5 years, respectively. This treatment was effective in controlling the disease, but bone marrow toxicity with severe pancytopenia developed in both cases. Both patients died from thrombocytopenia with haemorrhagic pericarditis. In one case, the diagnosis of acute myeloid leukaemia was established from the appearance of myeloblasts in the peripheral blood and from characteristic bone marrow morphology. In the other case this diagnosis was strongly suspected on the basis of the bone marrow morphology alone. It is proposed that this development of acute leukaemia in two patients with a primary non-neoplastic disease may result from a direct carcinogenic action of chlorambucil in humans.


Histopathologic criterion of dysplasia of the uterine cervix and its biological nature. A histopathologic diagnostic standard for abnormal epithelium of the uterine cervix, based on its biological behavior, has been proposed, and dysplasia and carcinoma in situ have been classified according to this standard. Benign dysplasia by this classification may be considered as a benign lesion, and only the lesion which satisfies the standard for atypical dysplasia should be considered as dysplasia, having a significance as a precursor to cervical cancer. This would be clinically convenient.


Ultrastructure of clear cell carcinoma of the vagina and the cervix. Report of a case with unusual ultrastructural findings. The ultrastructural study of a primary adenocarcinoma of the vagina with no history of maternal medication is described.  A 27 year old girl was found to have a clear cell adenocarcinoma.  The striking feature was the presence of vesicular aggregates in a large proportion of the nuclei.  The aggregates consisted of vesicles from 600 to 850 A in diameter and characterized by a single smooth membrane.  The aggregates were located in the nucleoplasm, the perinuclear cytoplasm, or between the 2 membranes of the nuclear envelope.


Familial amyloidosis with polyneuropathy. A clinical study based on patients living in northern Sweden.


An effective quality control program for the cytology laboratory.


The fine structure of exfoliated cervical and vaginal cells. In order to understand the means by which cellular aggregates were maintained in gynecologic samples, the fine structure of samples derived from a number of women of various ages was examined with special attention paid to the intercellular junctions. Most cells in the samples were squamous cells containing numerous intercellular fibrils and glycogen granules. Parabasal or intermediate cells were also seen as well as occasional endocervical cells. All of these cell types were often found as parts of aggregates and, while other cell junctions were present, desmosomes were the most prominent. It was concluded that desmosomes were probably responsible for maintaining the aggregated state of many of the cells found in gynecologic samples.


Assessment of patients for jaw deformity surgery.


The numerical composition of cellular samples from the female reproductive tract. II. Cases with invasive squamous carcinoma of uterine cervix.


Cells from the seminal vesicles: contaminants of the V-C-E smear. Cells originating in the seminal vesicles are occasionally observed on routing gynecologic smears. Sometimes, these cells may display large hyperchromatic dense nuclei, which conceivably may produce diagnostic problems. The identification of these cells is therefore of practical significance in order to avoid one more pitfall in gynecologic cytodiagnosis.


Interoral one stage subperiostal sliding osteotomy of the body of the mandible.


Fifty-three month persistence of ring chromosome in noninvasive bladder carcinoma. In a recurrent noninvasive papillary carcinoma of the bladder cytogenetic analysis by the direct technique was carried out on cystoscopic biopsies obtained at 53 month intervals. Persistent similar karyotypic abnormalities including aneuploidy, and ring and other marker chromosomes, the hallmarks of invasive cancer, were present in both specimens. In the 1973 specimen, DNA banding was identified in 35 per cent of the metaphases and in 56 per cent of the karyotypes. The continuing abnormal chromosomal silhouette of this tumor supports the stemline cell concept for malignancies, even when applied to such relatively benign neoplasms as this noninvasive carcinoma of the bladder.


Fractures of the orbit.

Fractures of the orbit.


A rapid, multiformat method for x-ray reproduction.


Developmental changes of protein, RNA, DNA, lipid, and glycogen in the liver, skeletal muscle, and brain of the piglet. A methodological and experimental study with special reference to protein synthesis.


Sensory impressions children receive in the dental office.


Oral cancer detection clinic.

Oral cancer detection clinic.


Consumer protection role of the Council on Dental Materials and Devices and its relationship to the FDA.


Nutritional aspects of high-altitude exposure in women. The nutrient intake and urinary excretion characteristics of eight young university women were studied over a 4-day period at low altitude (140 m) and subsequently over a 7-day sojourn on Pikes Peak (4,300 m). High-altitude exposure was associated with a transient decrease in the consumption of protein, carbohydrate, fat, sodium, calcium, phosphorus, vitamin A, riboflavin, thiamin, and niacin and a more sustained decrease in the consumption of potassium and ascorbic acid. In most instances minimal values were observed during the first 3 days of exposure. The carbohydrate fraction of energy intake was increased at the expense of fat during this time period. Individual hypophagic responses appeared to be related to severity of acute mountain sickness. Altitude had no effect on water consumption but did lead to an average body weight loss of 1 kg. Urinary measurements revealed a marked oliguria during the entire sojourn. These measurements also showed the first 3 days to be associated with a net loss of body nitrogen and sodium. During this time period body potassium and phosphorus were conserved, and probably increased. The urea fraction of body potassium and phosphorus were conserved, and probably increased. The urea fraction of total urinary nitrogen was not affected by altitude exposure, nor was the daily excretion of uric acid and creatinine. Ammonia excretion, however, was reduced to 50% of the low-altitude value and remained at this level throughout the sojourn. With a few exceptions, the qualitative characteristics of altitude hypophagia in women were similar to those reported for men. Quantitatively, however, the responses were much more transient in women.


Critical evaluation of the ANB angle.

Critical evaluation of the ANB angle. It has been demonstrated, first, in an empirical manner (qualitatively) and, second, in a geometric-mathematical manner (quantitatively) that the ANB angle depends not only on the anteroposterior relationship of the jawbones (which it should measure) but also on the maxillary inclination and maxillary prognathism, and slightly on the facial dimensions. Faces having the same anteroposterior value for the jawbones can have very different ANB angles (Figs. 3 and 4) and vice versa.


Open-bite relapse. Report of a case.

Open-bite relapse. Report of a case. Although the tooth positioner was initially helpful in promoting improved esthetics and stability, it in effect became an orthodontic appliance by maintaining the original, treated occlusal plane. Subsequently, the lower third molars erupted above the occlusal plane and caused the mandible to rotate downward and backward, resulting in an unsightly bite opening. Removal of the etiologic factors, the tooth positioner, and third molars corrected the open-bite relapse.


A handicapping malocclusion assessment study at West Virginia University. 1. The AAO Handicapping Malocclusion Assessment Record (HMAR) was tabulated using 100 before-treatment records and dental casts of patients presenting with permanent dentition. 2. The 100-patient sample exhibited scores ranging from 52 points to 11 points. A cut-off point was established at 30 points. This divided the sample into two groups of fifty patients each. This hypothetic situation accepted for treatment those with the fifty highest scores and did not accept those fifty with the lowest scores. 3. The accepted group had 70 per cent skeletal malrelationships (Class II and Class III), while the nonaccepted group presented with 32 per cent skeletal discrepancies. 4. Maxillary incisor interarch deviations were found in 48 per cent of the accepted group but in only 12 per cent of the group not accepted. 5. Mandibular incisor interarch deviation (overbite) occurred in 6 per cent of the nonaccepted group and in 54 per cent of the accepted group of patients. 6. Four patients who required rapid palatal expansion and one who had undergone a mandibular resection were in the nonaccepted group. It was shown that if these patients were examined clinically using the Supplementary Oral Assessment Record, 19 their dentofacial deviations would merit 16 additional points and all five would be promoted to the accepted group.


Orientation-sella-nasion or Frankfort horizontal. The controversy regarding the most appropriate line for cephalometric orientation has been resolved and can be summarized in the following five areas of consideration: 1. Clinical significance. The ability of the clinician to visualize the Frankfort horizontal plane affords him the opportunity for effective clinical communication, which is lacking with sella-nasion. In addition, he is able to demonstrate the orientation of the face, chin, and palate to Frankfort horizontal plane, which is also lacking in the sella-nasion system. 2. Anatomical significance. The direct relationship of the Frankfort horizontal plane with the basic sense organs of sight and hearing displays a relationship to the face. Sella, in contrast, relates to the brain and not the face. 3. Measurement accuracy. Studies performed to test the accuracy of selection of the planes under consideration showed no significant differences when true porion and not the ear rod was used and when experienced technicians performed the tracings. 4. Application in description. If the reference line is to be considered reliable for description, the correlation between the measurements of the maxilla and the mandible to the reference line should be minimal. In a study performed, SNA and SNB displayed a significantly higher correlation than N-Po to FH and N-A to FH. 5. Application in growth forecasting. A study was performed in order to evaluate the application of these lines of orientation to growth forecasting. In every instance the reference frame which utilized the Frankfort horizontal plane was appreciably better than that which utilized sella-nasion.


The use of the occlusogram in planning orthodontic treatment. A method of planning orthodontic treatment in the transverse plane has been presented. The occlusogram procedure outlined augments other orthodontic records in order to define more specifically the requirements of successful orthodontic treatment. Anchorage requirements, extractions, if any, and arch widths plus the final occlusal relationships can be determined at the outset of orthodontic treatment.


Letter to the editor: More on third molar enucleation.


Editorial: Orthognathic surgery and orthodontics.


The relationship between lower incisor inclination and various reference lines. The relationship between the inclination of the lower incisors and different cranial reference lines has been studied in a group of 60 children including 35 males and 25 females between the ages of 7-12 years. Following a 3-4 year observation period, 30 of these children were reexamined to study the relationship between changes in the position of the lower incisors and various craniofacial variables brought about by growth. In analysing the results obtained, an attempt was made to distinguish between those relationships which were to a certain extent due to a topographical relationship between the variables involved and those relationships which were of a biological character. The results obtained from the first registration indicated a strong correlation between Ll-NB mm and Ll-ML degrees and Ll-NB degrees. In addition, the connection between lower incisor inclination and the basal bone relationship (ANB degrees) was found to be strongly significant. The angle ML/NL was found to be correlated only with the inclination of the lower incisors to the mandibular line. Regarding the growth changes occurring during the observation period, no significant correlation could be found between, on the one hand, changes in lower incisor orientation and, on the other hand, changes in the angle ML/NL. The absence of this relationship has been interpreted as being due to the influence of environmental factors in the form of tongue and lip function.


The application of quantitative perioral assessment to orthodontic case analysis and treatment planning. Maximum tonicity of the lips can be accurately measured through the use of the pommeter. 2. Patients with significant hypertonicity of the lips whose maxillary central incisors are positioned oingualy as in Class II, Div. 2 and also in certain Class I malocclusions should be treated nonextraction and as early as possible. Torguing maxillary incisors into a more normal labial axial inclination is a form of expansion which does not detrimentally affect the position and function of the perioral muscles. In this early conservative approach not only is arch length increased but also marked improvement in the overbite is accomplished. These types of treated malocclusions should be retained until after the eruption of the second permanent molars. 3. If extraction is necessary in patients with hypertonic lip muscles it should be done as far as possible from the incisor teeth, preferably the second premolars. 4. In Class I malocclusions where maximum tonicity is in the normal range is to attempt to accommodate blocked out or rotated teeth within the framework of the perioral musculature surrounding the teeth...


A metal implant study of mandibular rotation.


Posttreatment and postretention changes following orthodontic therapy. This investigation was performed to determine the changes which occurred in treated orthodontic cases out of retention. The material consisted of 103 cases, of which 74 cases were treated nonextraction and 29 were treated with the extraction of four first premolars. The treatment was accomplished by the full-banded edgewise bioprogressive technique. Five measurements were taken: intercanine, inter-first premolar, intersecond premolar and inter-first molar widths, and incisor to molar distance. The measurements were made on the mandibular arch of the pretreatment, posttreatment, and prostretention casts. The postretention model was obtained a minimum of one year after all retaining devices were removed with an average of 5.2 years. The following conclusions were drawn from the changes in dimensions: 1. The intercanine width was expanded during treatment, but had a strong tendency to return to or close to its original pretreatment width in both nonextraction and extraction cases. 2. The inter-first premolar width showed the greatest treatment increase in width with only a minimal amount of postretention decrease. 3. The second premolar width for nonextraction cases showed a significant amount of increase with a slight tendency for postretention decrease. 4. The second premolar width for extraction cases showed a decrease with treatment and a slight continued decrease postretention. 5. The intermolar width of nonextraction cases showed a significant increase in width with treatment. The extraction cases showed a significant decrease with treatment. However, there were no changes in either extraction or nonextraction cases postretention. 6. The incisor to molar distance decreased with treatment and had a slight tendency to continue to decrease postretention.


Heat treatment of cobalt-chromium alloy wire. This study shows that the ability of cobalt-chromium wire to resist permanent deformation is definitely affected by the temperature of heat treatment. For each temperature of heat treatment up to 1200 degrees F there is progressively greater resistance to permanent deformation; at temperatures of heat treatment above 1200 degrees F, however, there is a rapid decline in resistance to permanent deformation due to partial annealing. The maximum resistance to permanent deformation occurs from heat treatment in the temperature range of 1100 degrees to 1200 degrees F. A clinician desiring maximum resistance to permanent deformation from a .016 inches x .022 inches cobalt-chromium archwire should heat-treat the wire at 1100 degrees to 1200 degrees F for 5 minutes in a dental furnace. If the wire was in a highly work-hardened condition as were the wire specimens of this study, he could expect an increase in resistance to permanent deformation of approximately 174 percent. Heat treatment at lower temperatures could be used in situations requiring less than maximum resistance to permanent deformation. Heat treatment at 900 degrees F would give approximately a 95 percent increase in resistance to permanent deformation. Of course, heat treatment would not be indicated when the desired level of resistance to permanent deformation was not greater than the amount exhibited in the untreated wires of this study. When an electrical resistance heat-treatment unit and 950 degrees F temper-indicating paste were used, the clinician would expect increased resistance to permanent deformation similar to that seen in the wires heat-treated with a dental furnace at 800 degrees and 900 degrees F, i.e., about half of that obtained by the 1200 degrees F treatment. This study has determined the effects that various temperatures of heat treatment have on the resistance to permanent deformation of cobalt-chromium wire specimens which were formed into a specific pattern of loops. The following conclusions can be drawn from the results of this investigation: 1. Heat treatment at 1200 degrees F gives the maximum resistance to permanent deformation to .016 inches x .022 inches cobalt-chromium wire. 2. Increases in resistance to permanent deformation of approximately 95 percent and 174 percent may be expected from heat treatment of .016 inches x .022 inches cobalt-chrome wire at 900 degrees and 1200 degrees, respectively. 3. Wires, heat-treated with an electrical resistance unit using 950 degrees F temper-indicating paste, exhibit increases in resistance to permanent deformation similar to wires heat-treated in a dental furnace at 800 degrees and 900 degrees F.


Orthodontic treatment of malocclusions caused by facial trauma. Assessment and orthodontic treatment of malocclusions caused by traffic accidents were reported. Different methods were employed to reestablish the harmony of the occlusion with consequent good facial appearance. Appliances like the activator and direct bonding techniques were illustrated. Principles and techniques of orthodontics play an important role in the treatment of the malocclusions left untreated at the time of surgical operation for the facial trauma.


Orthodontic elastic materials.

Orthodontic elastic materials. Latex elastics and synthetic elastomers have certain similarities and differences. In the fracture tests the latex elastics showed a greater amount of loss in strength than plastic elastomers when stretched over a 21 day period. There is a great variability, as much as 50%, in the tensile strength of the plastic materials taken from the same batch and stretched under the same conditions. The Ormco Power Chain was more resilient than the Unitek AlastiK chain. The Unitek AlastiKs had more force and stretched less. The force decay of synthetic elastomers, stretched over a specific length and time, exhibited a great loss in force. This loss could be as great as 73% during the first day. The decay of force continued at a slower rate during the rest of the 21 day period. Unitek AlastiK C2 double links, when stretched 17 millimeters, had a higher initial force averaging 641 grams (22.5 ounces) than the Ormco Power Chain which averages 342 grams (12.0 ounces). In one day the force was reduced to 171 grams (6.0 ounces) for both materials. The elastic materials within the same batch showed a great variation in the modulus of elasticity under different test conditions. The approximate force generated when stretched dry, within the elastic limit, was 22 grams per millimeter for 3/16 inches heavy latex elastics. The Unitek AlastiK C2 gave a force of 89 grams per millimeter, while the Ormco Power Chain had a value of 46 grams per millimeter. The modulus of elasticity of all of the materials was much lower after immersion in the water bath. The force decay under constant force application to latex, elastic, polymer chains, and tied loops showed that the greatest amount of force decay occurred during the first three hours in the water bath. The forces remained relatively the same throughout the rest of the test period. The elastic materials undergo permanent deformation in shape. The synthetic elastomers exhibited plastic deformation when the elastomers were stretched 17 millimeters for 21 days. In the dry condition the force decay was 63% for the Unitek chains and 42% for the Ormco Power Chain. The synthetic elastomers should be prestretched before being placed in the mouth. The elastomers should be used within their resilient ranges. Clinical treatment procedures should take into consideration the rapid initial force decay of elastic materials that occurs during the first day and the residual forces remaining.


Relationship of occlusion and periodontal disease: part IX-incisor inclination and periodontal status. In this study population the following observations have been made: Periodontal destruction, gingival inflammation and mobility were not significantly related to axial inclination of the incisor teeth. Labial gingival recession of the mandibular incisor was related to linguoversion (less than 85 degrees to GoGn). No other associations between incisor inclination and labial or lingual recession were found. Age was not related to either maxillary or mandibular incisor inclination. The periodontal-incisor inclination relationships reported above for periodontal destruction and gingival inflammation were not altered by the factor of age. Study of the secondary influence of incisor inclination on the relationships of selected occlusal factors and periodontal pathosis showed: A. Severe overjet (more than 6mm) had been found to be associated with more periodontal destruction. With severe overjet maxillary incisors in linguoversion (less than 100 degrees to SN) were somewhat healthier than all others. Among the same cases of severe overjet mandibular incisors in labioversion had slightly more disease than all others. B. The absence of a significant correlation between anterior overbite or crowding reported previously was not influenced by incisor inclination. C. Facial alveolar bone thickness, observed clinically, was studied for its relation to periodontal destruction and gingival inflammation. Thick facial alveolar bone was found to be associated with increased pathosis. This finding was not consistent for the maxillary and mandibular incisor and the influence of other factors might be suspected: Incisor inclination had no effect on the bone thickness-periodontal disease findings.


Current status of laser fusion research at Battelle.


Measurement of the cell migration index with a HeNe laser. Human diploid fibroblasts (WI38) were inoculated into Rose multipurpose culture chambers, using a high population density to develop confluency. After 24 hours, cells from a 1 mm swath were scraped from the center of the chamber. This cleared path was positioned to permit an unobstructed transmission of a 0.9 X 20 mm beam of light from a 1 mW HeNe laser. As cells migrated, at 37 degrees C, into the path of the laser beam the light scatter was recorded, using a photomultiplier tube. Because the amount of light scatter was proportional to the number of cells migrating into the beam, the system measured the migration index of the cells. Slight variations in the design of this device could facilitate data collection during surveys of toxic agents, fertility tests, and delayed hypersensitivity.


New developments in lasers at wavelengths of 3000 A and below.


Safety considerations in the laser research program at the Los Alamos Scientific Laboratory.


Current laser microirradiation studies.

Current laser microirradiation studies.


Laser organic chemistry: the laser photochemistry of quinones under aerobic conditions.


Coherent and quasi-coherent optical methods in biology and medicine.


Current laser surgery.

Current laser surgery. With the development of a suitable apparatus sufficient experience has been accumulated in clinical surgery to enable one to reach the conclusion that the CO2 laser has an application in all branches of surgery without exception, whereas it has a decided advantage over other modalities in (1) All operations where the anticipated blood loss is significant. (2) Operations performed on or through infected tissue. (3) Extirpation of malignant tumors. (4) Cavitational surgery involving the use of an endoscope or microscope.


Tumor destruction due to acridine orange photoactivation by argon laser.


Laser surgery in otolaryngology: interaction of CO2 laser and soft tissue. The sequence of histological change induced by CO2 laser irradiation was discussed in terms of two factors: the physiomechanical factor and the physiochemical factor. At sufficiently high heat energy levels, the immediate findings are characterized by crater formation resulting from rapid vaporization of the water and ejection of the solid component. In the immediate vicinity of the crater edge, the maximum tissue temperature rise is 65 degrees C above the 32 degrees C ambient tissue temperature and it decreases to the primary tissue temperature within a distance of 2 mm. The healing process of CO2 laser induced lesions proceeds with minimal delay. The lymphatic and vascular channels are occluded in the marginal area of coagulation resulting in a marked hemostatic effect. This sealing effect increases the margin of safety in preventing possible dissemination of tumor cells. By selecting the appropriate power, time, and focus cone angle, precise destruction of preselected areas of tissue can be achieved with an extraordinary hemostatic effect without damaging the underlying tissue. These advantages are especially helpful in function-preserving surgery.


Medical acoustical holography.

Medical acoustical holography.


Optical evaluation of ultrasonic scattering in animal tissue.


The laser in the current cancer program (1975).


The role of the laser in communications systems for improved medical care.


The safety aspects of atmospheric transmission of lasers.


Laser scanning of radiographs.

Laser scanning of radiographs.


Understanding the psychotic dental patient.


Prevention of periodontal disease and dental caries.


President's address.

President's address.


What do component societies need and expect from the ADA?


Licensure.

Licensure.


Alkaline phosphatase activity in the enamel organs of normal and rachitogenic rats.


Species differences in L-leucinaminopeptidase activity during tooth formation in the macaque monkey and rat.


Interaction between sympathetic and parasympathetic salivary nerves in anaesthetized dogs.


The mineralization of condylar cartilage in the rat mandible: an electron microscopic enzyme histochemical study.


The dental profession and the ADA Council on Legislation.


Ethics and the component dental society.


An adaptation of the rabbit ear chamber for use in pharmacological investigations.


The histology and microbiology of acute occlusal dentine lesions in human permanent molar teeth.


A (3H)-proline autoradiographic study of dentine bridge formation in transplanted mouse molar teeth.


Guidelines for counseling committee.

Guidelines for counseling committee.


Immunogenic properties of human and rabbit salivary albumin.


Keynote address 1975 ADA regional conference.


Management counselor.

Management counselor.


The rate of reparative dentine formation in transplanted mouse molar teeth.


Fine structural localization of alkaline phosphatase in relation to enamel formation in the mouse molar.


Separation of human enamel structures by density fractionation.


The effect of fluoride on the immature enamel matrix protein of the rat.


Multivariate analyses of the influence of mottling doses of fluoride on the amino acids of enamel matrix protein of rat incisors.


A preliminary report on human enamel demineralization in an artificial mouth.


Dental education in Arizona.

Dental education in Arizona.


Electron microscopy of ion-sputtered human enamel.


The effect of artificially produced pellicle and plaque on the uptake of 18F by human enamel in vitro.


A denervation study of taste buds in the soft palate of the albino rat.


The role of host tissue in repair of transplanted mouse molar teeth: a reappraisal of induction of odontoblasts during tooth development and repair.


Pain perception to electrical stimulation of the periapical tissues in human subjects and the possible influence of disease.


Bacteriocinogeny and the properties of some bacteriocins of Streptococcus mutans.


Continuing education.

Continuing education.


A device for surface cooling and rewarming in operations on the "dry" heart in babies and children during moderate, deep and profound hypothermia. Following a clinical experience of 100 cardiac operation in infants durind deep hypothermia, as low as 15C, the authors have designed a new bath for the procedure which incorporates several improvements over those used previously. The device described allows continuous cooling or rewarming of the patient at any stage of the operation by addition of more cold or hot water as required. It is possible to operate with the patient prone or on the side at any level of hypothermia, and while using heart lung bypass. The construction facilitates the even distribution of the circulating water, and a thermostatic control allows the temperature to be fixed at any level required.


Tracheal injury following prolonged intubation. Prolonged respiratory assistance by positive pressure ventilation via cuffed tracheostomy or endotracheal tube can be complicated by mucosal erosions, tracheal stenosis, tracheomalacia, excavation of the tracheal wall with loss of tissue and tracheoesophageal fistula. Stenosis can occur at the subglottic region, at the stoma, or at the cuff site, whereas the other complications occur most often at the cuff site. This paper is concerned with complications occurring below the first tracheal ring.


Splenectomy: a review of morbidity.

Splenectomy: a review of morbidity. One hundred and fifty consecutive splenectomies, performed at the Royal Prince Alfred Hospital over a five-year period beginning in 1968, have been reviewed in a retrospective study. Splenectomy incidental to some other resectional procedure in the upper abdomen carried a mortality of 17%, accidental injury to the spleen during upper abdominal surgery carried a mortality of 28%, external trauma to the spleen a 7% mortality, while splenectomy for the diagnosis or therapy of a haematological disorder carried the lowest mortality, namely 4%. Morbidity and mortality were related to the age of the patient, and the mortality among patients 60 years or more was 26%. Pulmonary complications (excluding pulmonary embolus) occurred in 48% of patients. Clinically evident thromboembolism was detected in 10.7% of patients. A definite relationship to platelet counts of more than 500,000/mm3 was noted amongst patients who were not heparinized. Splenectomy is associated with a high morbidity and a significant mortality. Surgeons performing the operation and physicians referring patients for splenectomy need to be aware of the risks involved. Careful patient selection, scrupulous perioperative management, and meticulous surgery may reduce both morbidity and mortality. Elective splenectomy should be managed by a team of surgeons and physicians with a specific interest in the problems involved.


Benign osteoblastoma.

Benign osteoblastoma. Benign osteoblastoma is a benign bone-forming lesion, seen most commonly in the first three decades of life and having a predilection for the vertebral column and the short limb bones. It is distinguishable from osteoid osteoma on the bases of size (being more than one centimetre in diameter) and the absence of surrounding sclerosis. The two lesions, however, are probably of the same origin and behave differently because of their different situations. Treatment is by operation, either excision in whole if practicable, or thorough piecemeal excision and curettage, with bone grafting of the defect if indicated.


Peptic stricture of the oesophagus: the role of oesophagogastrostomy. Sixteen patients with severe peptic stricture of the oesophagus were treated by oesophagogastrostomy at the Royal Children's Hospital, Melbourne, during the period 1948 to 1968. It has been possible to obtain a follow up on all patients, so that the period of follow up has varied from seven to 24 years. Although the early postoperative results were promising, later problems occurred in over half of the patients, the major complication being recurrence of peptic stricture at the anastomotic site.


Clostridial infection in total hip joint replacement: a report of two cases. Two cases of clostridial cellulitis are presented in patients who had Charnley total hip joint replacement for severe osteoarthritis. Early deep infection can be a major problem in this operation, and is usually due to Staphylococcus aureus.


Hernia through the foramen of Winslow.

Hernia through the foramen of Winslow. This is a report of a hernia through the foramen of Winslow in which the right half of the colon was herniated. It was gangrenous and perforated. Following hemicolectomy the patient recovered.


Synovial chondromatosis of the shoulder. Articular synovial chondromatosis is a rare disease commonly affecting the knee, hip or elbow, and characterized by the formation of metaplastic cartilaginous foci in the synovium. A case of cynovial chondromatosis affecting the shoulder joint is now reported because of the extreme rarity of the disease in this situation.


Tropical intussusception in adults.

Tropical intussusception in adults. In contrast with the incidence in Britain and the United States, about 50% of intussusceptions in Sri Lanka occur in adults, the maximum age incidence being in the fourth decade. Seventy-six cases of intussusception in adults are analysed in this paper, 62 of which were of the caecocolic type, which though only rarely described in the West, have also been frequently reported from other tropical countries. The clinical picture was characteristic, and a mass was palpable in 90% of the patients, facilitating diagnosis without ancillary investigations. On the basis of the histological examination of resected specimens it is concluded that amoebic granulomatous formation in the dependent "diverticulum" of the caecum is the predisposing cause of the caecocolic intussusception, accounting for the chronicity of a large number of cases. Irrespective of the duration of the illness, gangrene did not occur in any of the cases if this type, although resection was occasionally required on account of irreducibility. In view of the proliferation of fibrous tissue in the wall of the caecum, complete evagination of the intussusception can only be achieved by surgical exploration and manipulation, the results of which are excellent.


The place of ileorectal anastomosis in Crohn's disease. A study of 41 patients who underwent ileorectal anastomosis for Crohn's disease has shown this operation to be a relatively safe procedure with an immediate mortality of 2.5%. A defunctioning ileostomy may protect the patient against the consequences of anastomotic leakage. Ileorectal anastomosis is associated with a high early recurrence rate and on overall failure rate of up to 50% because of recurrence, intractable diarrhoea and exacerbation of perianal disease. However, half of the patients are able to retain the anastomosis and be restored to long-standing good health. The surgical philosophy in this Centre has largely evolved from treatment of small-bowel Crohn's disease, that is, resection of only the worst areas of involvement with the aim of symptomatic relief, and the results shown by this survey encourage us to pursue this policy by using ileorectal anastomosis for diffuse colonic disease, particularly if the rectum is uninvolved.


Ischaemic ileal necrosis and carcinoid tumour. A case of ischaemic ileal necrosis is reported. It was associated with elastic vascular sclerosis produced by mesenteric metastases of an ileal carcinoid tumour.


One-stage repair of distal hypospadias.

One-stage repair of distal hypospadias. This paper reviews a short series of patients with distal hypospadias who were treated by Mustarde's one-stage technique, to which we have added a minor modification by tubing the flap before penis tunnelization. A single-stage repair has obvious advantages over a more conventional multistage procedure. The advantage of tubing the flap is early healing, and it reduces the risk of fistula formation, even in the presence of infection, which is very common in this country. The new urethral opening is situated at the fossa navicularis, and the functional results are excellent.


Pineal tumours: a clinical study of 23 cases. A series of 23 cases of pineal tumours is presented, and their salient clinical features are analysed. The rationale of the present trend of treatment is discussed, and the relevant literature is reviewed.


Haemangiomatous malformation of the orbito-sphenoidal region: cure by radiotherapy. This case was previously reported in 1973 at the 46th annual general scientific meeting of this College. Following a suggestion made at the meeting the patient was referred for radiotherapy, with a result so satisfactory as to call for a restatement of the case.


Retroperitoneal liposarcoma.

Retroperitoneal liposarcoma. The diagnosis of retroperitoneal fatty tumour is not extremely difficult provided that the possibility of its presence is kept in mind by the surgeon in all cases of distended abdomen in an apparently well-nourished patient. A careful clinical examination and a good excretory pyelogram are very important in the diagnosis. Surgical excision requires a considerable amount of patience and boldness on the part of the surgeon and is always gratifying, even if the tumour cannot be totally removed. Three cases of retroperitoneal tumour treated by us are presented. All three had had previous unsatisfactory treatment, the first two being incorrectly diagnosed and the third being inadequately excised. The pathology, diagnosis and treatment of these tumours are briefly discussed.


Perianal vaccinia: a case report.

Perianal vaccinia: a case report. Accidental perianal vaccinia is a rare condition, presenting acutely with severe pain and characteristic superficial ulceration. There is no specific treatment, and complete resolution occurs. A case is described of autogenous perianal vaccinia occurring in an adult.


A neck incision.

A neck incision. A "hockey stick" neck incision is recommended for laryngectomy with neck dissection, especially when the surgery follows radiotherapy.


The detection of serological factors in acute ulcerative colitis indicating a favourable short-term prognosis. Large-intestinal epithelial cells were obtained from operation specimens and by biopsy at sigmoidoscopy from 16 patients with acute severe mucosal ulcerative colitis and II control subjects with normal large-bowel mucosa. The ability of lymphocytes to release 51Cr label from large-intestinal epithelial cells was quantitatively assessed as percentage lymphocyte activity. The mean +/- standard deviation of percentage lymphocyte activity in 16 patients with acute ulcerative colitis on admission to hospital (88 +/- 8) was significantly greater than that in II normal subjects (16 +/- 8) (P is less than 0.01). In each study, samples of autologous serum were added to two reactions between lymphocytes and autologous large-intestinal epithelial cells. The results in the seven patients who came to urgent colectomy differed significantly from those in the nine who responded to corticosteroids. The mean +/- S.D. of percentage serological inhibition of lymphocyte activity in the group coming to colectomy was 44 +/- 16, and in those responding to steroids 12 +/- 5. When the serum of these patients was studied for immunofluorescent autoantibodies to normal human colonic mucosa, none of the seven patients treated by colectomy had detectable autoantibodies, in contrast with three of the nine patients with a more favourable short-term prognosis, in that they responded to steroid treatment.


Dental photography.

Dental photography.


Physical properties of orthodontic wires.


Experimental coronary occlusion in calves: the effect of hyperglycaemia on ventricular fibrillation threshold. Measurements of ventricular fibrillation threshold (VFT) were made in two groups of bovine calves, each weighing 25 to 30 kg, before and after ligation of the anterior descending branch of the coronary artery. In the control group, the VFT was determined before occlusion of the anterior descending coronary artery, and the observations were repeated at 20-minute intervals after occlusion. A 33% reduction in VFT was observed 20 minutes after the occlusion. Prior loading with glucose by infusion of 100 ml of 10% glucose prevented the significant fall in VFT.


Case history: temporo mandibular joint dysfunction in a seven year old child.


Who says that child needs orthodontic treatment?


The possible role of the Western Australian dental therapist in the practice of orthodontics.


The tooth positioner -- use and fabrication.


Changing outlook for child with cancer.

Changing outlook for child with cancer.


Indications for His bundle recordings in the clincial practice of cardiology.


Medicine and the crisis in confidence.

Medicine and the crisis in confidence.


The heart and la mort d'amour (muerte por amor) sex, sudden death and the heart.


Analysis of electrocardiographic abnormalities other than "ischemic" s-t depression occurring during submaximal treadmill exercise testing.


BUDR inhibition of post-DMSO-induced erythroleukaemia cell differentiation in vitro.


Trapping and destruction of blood-borne syngeneic leukaemia cells in lung, liver and spleen of normal and leukaemic rats. Leukaemic cells from rats with a lymphoid (HRL) or myeloid (SAL) leukaemia were labelled with 125IUDR and injected i.v. into either normal or leukaemic syngeneic recipients. The fate of the injected cells was studied in terms of the radioactivity in various tissues at various times up to 24 h later. In normal animals the leukaemia cells were destroyed rapidly in the reticulo-endothelial (RE) system; immediately after injection most recoverable activity was in the lung, with smaller amounts in the blood, spleen and liver but by 24 h only 20-30% of the injected activity could be recovered. In leukaemic recipients with high numbers of blasts in the blood the amount of activity recoverable from the lungs and bone-marrow was markedly reduced, while that in the blood was doubled. Nonetheless, the overall rate at which radioactivity was eliminated was not significantly different from that found in normal rats, in spite of the fact that the RE system was extensively infiltrated by leukaemia cells.


Response of remission lymphocytes to autochthonous leukaemic myeloblasts. Thymidine incorporation in vitro by remission lymphocytes from a total of 6 patients with acute myeloid leukaemia (AML) was measured following stimulation by autochthonous and allogeneic AML blasts and cell lines. The early peak response to autochthonous blasts in 2 of these patients (48-72 h) is consistent with the concept of a population of lymphocytes pre-immunized to antigens carried by the blasts. Although stimulation in one patient was increased in the presence of more stimulating (S) blasts than responding (R) lymphocytes, positive responses in other tests were obtained at an S : R ratio of 1 : 1-5. When different methods of treatment of the stimulating autochthonous blasts were compared with untreated cells, mitomycin C gave the highest stimulation indices 2 out of 3 tests. Tissue culture medium in which autochthonous blasts had been incubated for 3-5 days failed to stimulate either remission lymphocytes alone, or combined cultures of lymphocytes with autochthonous or allogeneic blasts, suggesting that mitogenic factors released from autochthonous blasts are not responsible for lymphocyte stimulation. Treatment of autochthonous or allogeneic AML blasts with glycine-HC1(pH 3-0) to remove putative "blocking" factors failed to increase the stimulatory capacity of the leukaemic blasts.


Chemotherapy of the blastic phase of chronic granulocytic leukemia: hypodiploidy and response to therapy. Thirty-two patients in the blastic phase of Philadelphia chromosome-positive chronic granulocytic leukemia (CGL) were studied in a prospective randomized trial in which vincristine--prednisone (19 patients) was compared with cytosine arabinoside--6-thioguanine (13 patients). Seven remissions (37%), including two complete remissions, were achieved in the vincristine--prednisone group. Three of the five with predominant hypodiploid blast cell lines treated with vincristine--prednisone had complete or partial remissions. Both complete remitters presented with hypodiploidy consisting of 44 chromosomes. Four patients (30%) who were treated with cytosine arabinoside--6-thioguanine responded with one complete remission. The median survival of the responders was 8 mo, as compared to 1--2 mo for the nonresponders. Crossover to the opposite regimen as secondary therapy following refractoriness or resistance resulted in only 3 partial responses out of 21 treated. All three had previously responded to vincristine--prednisone. Of the 32 cases, 14 had an elective splenectomy during the chronic phase of the disease. Prior splenectomy did not influence the response to chemotherapy, as all three complete remitters occurred in the nonsplenectomized group. Similarly, survival in the blastic phase was not affected by prior splenectomy.


Nuclear DNA-polymerase estimation in human leukaemic myeloblasts. A technique which detects the presence of DNA-polymerase in cell nuclei by measuring the incorporation of 3H-thymidine-5-triphosphate (3H-TTP) has been used to estimate the proportion of leukaemic myeloblasts which contains DNA-polymerase and DNA capable of acting as primer-template. In six cases of previously untreated acute myeloid leukaemia the 3H-TTP labelling index (3H-TTP LI) was much larger than the fraction in DNA synthesis. After a single 'flash' injection of cytosine arabinoside a pronounced decline was observed in the 3H-TTP LI, which can be explained by a direct inhibition of NDA-polymerase. No change was observed in the fraction of cells labelled with 3H-thymidine. A decrease in 3H-TTP LI was also observed after a single i.v. dose of methotrexate.


Letter: Acute leukemia in Iran.

Letter: Acute leukemia in Iran.


Ultrastructure of chronic megakaryocytic-granulocytic myelosis. To study chronic megakaryocytic-granulocytic myelosis, bone marrow biopsies from 5 patients were obtained. Ultrastructural quantitative and qualitative assessments demonstrate proliferation of both the megakaryocytic and granulocytic cell lines. Factors indicative of malignant growth in megakaryocytes included atypical maturation, nuclear-cytoplasmic asynchrony, nuclear inclusions and production of micromegakaryocytes. Abnormal thrombocyte delineation provoked giant platelet production. The neutrophil series also presented atypia as generally observed in chronic myelogenous leukemia. Even in cases without evidence of myelofibrosis under the light microscope, megakaryoblasts were associated with fibrillar structures. These cells may be responsible for the initial step in fibrillogenesis by providing a medium conductive to the collagen formation found in later stages of this disease.


Emergency management of cardiac arrest.

Emergency management of cardiac arrest.


Editorial: Capitation.

Editorial: Capitation.


Certification.

Certification.


Emergencies in the dental office.

Emergencies in the dental office.


Spotlight on public dental service society.


Editorial: Congress wants higher dental costs.


National Health Federation cancer scare refuted; no fluoridation-cancer link, claims government.


Replanting and transplanting teeth. Part two.


Enucleation of cyst and apicectomy of lateral incisor.


Editorial: Find another dentist.

Editorial: Find another dentist.


The use of composite for recementing crowns.


Editorial: As the world turns.

Editorial: As the world turns.


Pins-and-resin alternative to conventional crowns.


A philosophy of the practice of dentistry.


Editorial: Liberty or death.

Editorial: Liberty or death.


Tissue conditioning denture reliners.

Tissue conditioning denture reliners.


To hell with ethics.

To hell with ethics.


Editorial: Dear member of the CDS.

Editorial: Dear member of the CDS.


Why x-ray children's teeth?

Why x-ray children's teeth?


Oddments in dental history: dentists have always been suckers for poetry.


President's page. Support and participation.


Editorial: Who am I if I am not a tooth scraper?


Comments on primary care.

Comments on primary care.


Rabies in New York City, with new guidelines for prophylaxis.


Six cases of Gilles de la Tourette's syndrome. Six cases of Gilles de la Tourette's syndrome are discussed in the light of conflicting views on the aetiology of the condition. It is hypothesized that the onset of coprolalia in patients with persistent childhood tics indicates a disturbances of the normal balance between a need for tension relief by swearing and a capacity to control such vocal activity. Some conclusions are drawn on the management of the syndrome by the use of butyrophenones, massed practice of tics, and the promotion of personality development. A flexible approach geared to the individual patient's particular needs is recommended.


Malignant interstitial cell tumor of the testis: a problem in endocrine onocology.


Editorial: Measles encephalitis during immunosuppressive treatment.


Conception and congenital abnormalities after chemotherapy of acute myelogenous leukaemia in two men.


Atypical measles infections in leukaemic children on immunosuppressive treatment. One case of giant-cell pneumonia and two of encephalopathy, all due to measles infection in children in leukaemic remission on immunosuppressive treatment, were seen recently. The clinical syndromes were variable and atypical and the antibody responses unpredictable. Conventional doses of pooled immunoglobulin failed to protect the two children to whom it was given. Degeneration rather than inflammation seems to characterise the encephalopathy in immunosuppressed children infected with measles virus.


Acute myelomonocytic leukaemia and multiple myeloma after sulphinpyrazone and colchicine treatment of gout.


Use of liposomes in treating type II glycogenosis.


Antitumor activity of N-(phosphonacetyl)-L-aspartic acid, a transition-state inhibitor of aspartate transcarbamylase. N-(Phosphonacetyl)-L-aspartate (PALA) is an analog of the transition state for the aspartate transcarbamylase reaction and has been reported previously to be a potent and specific inhibitor of de novo pyrimidine nucleotide biosynthesis. It is now shown that PALA has considerable antitumor activity against certain transplantable tumors in mice. PALA, unlike other antimetabolites, was less effective against ascitic leukemias than against two solid tumors, B16 melanoma and Lewis lung carcinoma. Another solid tumor, Ridgway osteogenic sarcoma, which is sensitivie to many established chemotherapeutic agents, did not respond to PALA. Daily or intermittent treatment with PALA did not significantly increase the life-span of mice bearing i.p. leukemia L1210. The survival time of mice bearing i.p. P388 leukemia was prolonged by PALA treatment by up to 64%. In a number of experiments mice bearing i.p. B16 melanoma survived 77 to 86% longer than did controls when treated with PALA (490 mg/kg) on Days 1, 5, and 9. Lewis lung carcinoma, a tumor refractory to most established antineoplastic agents, was highly sensitive to PALA. Treatment on Days 1, 5, and 9 following s.c. implantation of Lewis lung carcinoma was curative to 50% of the mice. If treatment was delayed until s.c. Lewis lung tumors had reached about 500 mg, PALA neither cured the mice nor produced significant tumor regression. However, extensive delay of tumor growth and prolongation of survival were still observed.


Elaboration of pyrimidine-specific nucleosidases by human lymphoblastoid cells of established cultures. Pyrimidine-specific nucleosidases were released rapidly by human lymphoblastoid cells of established cultures when incubated under certain culture conditions having no adverse affect on their viability or morphology. Nucleosidase production was not restricted to any particular type of lymphoblastoid line; enzymes with a high level of activity were elaborated by cells of cultures initiated from healthy subjects and patients with uncontrolled lymphocytic or myelocytic leukemia, as well as by cells of cultures exhibiting mostly B- or T-cell properties. Tritiated thymine and uracil, which were not incorporated to any appreciable extent by DNA- and RNA-synthesizing cells, were identified by paper chromatography as the primary products arising from nucleosidase degradation of radiolabeled thymidine, uridine, and cytidine. Neither adenosine nor guanosine was catabolized. These heat-labile and ultraviolet-sensitive enzymes with a molecular weight of  5 to 10 X 10(4) did not affect the viability, morphology, or proliferation of lymphocytes in mitogenactivated cultures, lymphoblastoid cells in long-term cultures, or fibroblasts in monolayer cultures.


Biologic activity of two derivatives and six possible metabolites of cyclophosphamide (NSC-26271). The biologic activity in terms of survival of normal hematopoietic stem, osteosarcoma, and L1210 leukemia cells was determined for the following compounds:cyclophosphamide, its derivatives isophosphamide and trophosphamide, its possible metabolites nor-nitrogen mustard, hydroxylamine mustard, 4-ketocyclophosphamide, and and acrolein, and two substitutes for its primary active metabolite 4-hydroxycyclosphamide anhydro-dimer (4-hydroxy-CP-anhydro-dimer) and 4-hydroperoxycyclophosphamide (4-hydroperoxy-CP). On a molar basis none of the compounds shows a better therapeutic ratio between osteosarcoma and bone marrow stem cells than the parent compound. The therapeutic ratio between L1210 leukemia and normal cells is slightly better for 4-hydroperoxy-CP only. It may be concluded that the conversion of 4-hydroxy-CP-anhydro-dimer and 4-hydroperoxy-CP to the primary active metabolite 4-hydroxycyclophosphamide differs quantitatively. Moreover, it appears that by the use of these precursors a better therapeutic ratio might be obtained for some malignancies but not for others.


Studies on the enhancement by cyclophosphamide (NSC-26271) of artificial lung metastasis after labeled cell inoculation. In a mouse model the retention of125I-5-iodo-2' -deoxyuridine-labeled tumor cells in the lung after iv injection was compared with the formation of tumor colonies in the lung 15 days after injection. The modification in lung retention after treatment with cyclophosphamide (CP), isophosphamide, Corynebacterium parvum, and heparin paralleled the changes in lung-colony numbers by these treatments. Since the modifications could be identified as early as 1 hour after iv administration of tumor cells, further evidence was obtained for the conclusion reached earlier that the modification of lung metastases by CP and Corynebacterium parvum is not due to immunologic mechanisms. Comparison with the lung retention of heat-killed tumor cells and living embryonic cells showed that CP induced an increased retention of all three cell types. In contrast, Corynebacterium parvum decreased the retention of living tumor cells, but failed to modify the retention of dead tumor cells, but did not affect the retention of living embryonic cells. Since no similar cell types were affected by the various treatments it seems likely that different mechanisms are involved. Apparently CP decreases the nonspecific resistance against the lodging and growth of any type of cell in the lung.


The Paneth cell in the adenoma of familial polyposis coli. It is said that the Paneth cells are found in the large intestine in a pathological state such as ulcerative colitis or adenoma. We examined the Paneth cells in the adenomas of familial polyposis coli. Nine cases including one case of Gardner's syndrome comprised the material for the examination of the Paneth cells because the caecum was available for the examination. The remaining one case had no Paneth cells. In two cases, the Paneth cells were found among the adenomas in the areas beyond the caecum and the proximal part of the colon ascendens. In one remarkable case, the Paneth cells were found in 43% of the adenomas in the caecum. Seven cases were carcinomas but no Paneth cells were found in or near the carcinoma. In the control cases, which were taken from the resected colon with a disease other than familial polyposis coli, the Paneth cells were found confined to the caecum. We concluded that the distribution of the Paneth cell-bearing adenomas reflects the distribution of the Paneth cells in the normal mucosa of the large intestine and that the Paneth cells in the adenoma may have differentiated in the adenoma.


The physiological responses to walking uphill under hot environment. A series of human experiments on walking uphill under radiant heat in addition to hot environment were carried out and the safety conditions for walking uphill from the standpoint of physiological response were determined. Experiments were carried out on three healthy adult males aged 21 years, walking uphill on a motor-driven treadmill with the aim of walking at a speed of 45 m/min, 55 m/min and 65 m/min and with a slope gradient of 0 degrees, 5 degrees and 10 degrees. The load weight used was 30, 40 and 50 percent of the body weight for each combination of speed, gradient and load weight. The subjects were exposed to a radiant heat of 1.3 cal/cm2.min, using 12 exsiccating infrared lamps, with a room temperature of 33 degrees C, a relative humidity of 60% and an airflow of 0.7 m/sec. The following results were obtained by estimating the physiological response (heart rate, respiration rate, rectal temperature and RMR (relative metabolic rate)) to different degrees of walking conditions during the 10-minute exercise: 1) The work intensity (RMR) of uphill walking with a certain load weight under hot environment can be changed by varying the walking speed and the load weight according to the slope gradient. 2) As there exists a gap between RMR 5 and 6 in parallel with the other physiological responses, it is preferable to keep the walking condition under RMR 6, as viewed from the change of the other walking conditions. 3) The heart rate as an indicator of the work load must be kept below 130 beats/min for a safe uphill walking of under RMR 6.


Radioisotope scanning for the spinal cord tumor. Radioisotope scanning with 99mTc-pertechnetate or 67Ga-citrate for the spinal cord tumors was reported. Six patients with spinal cord tumors including 2 ependymomas, 1 neurinoma, 1 metastatic medulloblastoma, 1 metastatic astrocytoma, and 1 metastatic pinealoma as well as 6 patients with non-neoplastic lesions were examined with this method. Two out of 6 cases with tumors showed positive scans and two equivocal scans. This new method is different from myeloscintigraphy and radioisotope angiography as already reported. It directly demonstrates tumor itself like brain scanning and is very useful as nontraumatic method for screening spinal cord lesions, especially in poor risk patient. The usefulness and limitation of this method are discussed.


Cleavage lines in the oral mucosa and oral scars. Previously published data on the mucosal cleavage lines were compared with data on the formation of scar tissue after palatoplasty and it was found that, in the palate and surrounding tissues, scar formation is light when incisions are parallel to the long axis of the cleavage lines but severe when incisions are made at right angles to the cleavage lines. A few cases were also found where jaw movement was severely restricted because of the formation of hypertrophic scar between the upper and lower alveolar ridges. It is therefore desirable that surgical incisions in thepalate and surrounding tissues be made parallel to the long axis of the mucosal cleavage lines.


Treatment of restricted jaw movement due to scars after palatoplasty. In order to correct the condition or restricted jaw movement due to hypertrophic scar tissue after palatoplasty, the scar is first cut laterally. After cutting away the scar tissue from under the mucosa and suturing the incision longitudinally, a drastic improvement in free faw movement is obtained.


In vitro studies of bone resorption by the root-resorbing tissue from the bovine deciduous tooth. Granulation tissue which is responsible for root resorption of deciduous tooth lies between root of the deciduous tooth and its permanent tooth germ. This tissue is called "root-resorbing tissue". Its bone-resorbing activity was investigated in vitro. Bovine root-resorbing tissue was cultured in close contact with 45Ca-labeled dead calvaria of rats. Bone-resorbing activity was determined by measuring 45Ca released from labeled calvaria during culture. It was found that only the root-resorbing tissue which was rich in odontoclasts and had a good blood supply in its surface layer had bone-resorbing ability, and that bone resorption occurred only when it was placed in close contact with calvarium. The root-resorbing tissue which was poor in odontoclasts and blood vessels failed to stimulate by 25-hydroxy-vitaim D3 or heparin, but not by larger amounts of parathyroid hormone, vitamin D3, and dihydrotachysterol when added to the culture.


Clinical studies on diabetes mellitus and diseases of the oral region. Of the 25,672 patients who visited this clinic between January 1964 and March 1973, 126 were diabetic. These were examined statistically and the following results were obtained. 1. Together with diabetes the following disorders pertaining to the realm of oral surgery were observed: Alveolar pyorrhea (49 cases), infection of oral tissues other than periodontal tissues (24 cases), simple periodontitis (15 cases), tumors (13 cases), dental caries (9 cases), neuralgia (6 cases) and several disorders. 2. Of these 126 cases, 85 needed tooth extraction, which was actually performed in 67 cases with the following results: (a) Of the 67 cases, 13 developed complications such as dry socket, postoperative infection, sequestrum around the extraction socket, etc. This was a significantly higher incidence than in an equal number of controls. (b) In the cases with complications convalescence was prolonged to an average of 54.2 days. (c) In the cases with complications, the preoperative fasting blood sugar level averaged 194.5 mg/dl, which was much higher than in the cases which did not develop complications (average 142.4 mg/dl).


A clinico-pathological survey of exophytic tumors of the urinary bladder. I. An analysis of the structure of the fibro-vascular cores with special references to the clinical prognosis. In this paper the results of the clinicopathological study on a total of 79 bladder tumor cases are presented. They are principally related to the stromal proliferation or branching of the tumors. The tumor cases consist of those with a good prognosis as well as those with a poor prognosis. In the former category there are 61 cases with a long survival history (with or without recurrence); the remainder (18 cases) had a history of a short survival (dying within 2 years). Histologically there was a marked difference in the regularity of the stromal branching of the tumor between those cases with a long survival history and those cases with a short survival history. In the former group the regular type of stromal branching was predominant; in the latter group the irregular type was predominant.


Renal microvasculature in chronic renal failure. The renal microvasculature was examined stereoscopically after intraarterial injection of silicone rubber. Specimens studied were: 29 cases of normal kidney, 4 cases of sclerotic kidney, 10 cases of acute renal failure, and 10 cases of chronic renal failure from the final stage of chronic glomerulonephritis, malignant nephrosclerosis, diabetic nephropathy, and cortical necrosis. The following were common evidences for chronic renal failure: much reduction and wide deficiencies of filling in the cortex, increased filling of vasa recta, narrowing and spiralling of interlobular arteries and cortical afferent arterioles, appearance of giant glomeruli, rarefaction of the peritubular capillary plexus, and relative preservation of glomeruli in the juxtamedullary zone and vasa recta in the medulla may be the major pathway, after the interlobular arteries and afferent arterioles in the subcapsular cortex are destroyed, and these vascular architectural changes may be intimately related to the pathophysiology of chronic renal failure.


The color of gingiva studied by visual color matching. Part I. Experimental studies on the discrimination threshold for color difference and effect of training. As a preliminary experiment on the gingival color indicated by Munsell system, the makings or the qualities for color sensation of the individual were checked with regard to (1) discrimination threshold for color difference with certain color range of gingiva (paired difference test for color comparison) and (2) promotion of memorial power by training (test for memory color). A total of 20 males and females (20-30 years old) participated in this preliminary study as experimental subjects and the following results were obtained: (1) the average color discrimination threshold for color difference among subject trained for color memory is 0.8 Lab. (Hunter), and is assumed to be greater in the actual colorimetry of gingiva, (2) the similarity of discrimination is more frequent among the subjects trained for color memory than among those who were not trained, and (3) training for color memory is found to be effective in promoting the ability for color discrimination.


Osteogenic sarcoma metastatic to the kidney.


Interaction between polymeric materials and tissue -- biodeterioration of polymeric materials. Styrene-isoprene block copolymer/methyl methacrylate graft copolymer (SIS-MMA), styrene-butadiene block copolymers (SBS), polyethylene, 1,2-polybutadiene, polysulfone, polycaprolactone polyurethane (PU) and ethylene-vinyl acetate copolymer (EVA) were implanted subcutaneously in dogs for 1 year. The same materials were stored in physiological saline solution at 37 degrees C (in vitro) and in air at room temperature (in air) for 1 year for comparative purpose. Biodeterioration or biodegradation of these materials was studied by mechanical property testing, viscometry, x-ray diffractometry, infrared spectroscopy and microscopy. A little deterioration of the mechanical properties of all the implanted samples was noticed as compared with the samples stored in vitro and in air. The infrared spectrum and x-ray diffraction pattern of the implanted sample except SIS-MMA were practically identical with the control. The implanted samples of SIS-MMA and SBS showed a cracked surface under a differential interference microscope. Viscosity measurements suggested a possible main chain scission for SIS-MMA and cross-linking for SBS and showed that the molecular weight of the other materials was almost unchanged. The intactness was rather surprising in regard to the infrared spectrum and viscosity of PU and EVA, because they were supposed to be more biodegradable. Deterioration of the mechanical properties was not always due to the results of biodegradation, as is often believed, but it must be considered that it might also be due to the absorption of some constituents such as lipids, steroids and amino acid from the body fluids and/or leaching of low molecular weight substances from the implanted materials.


An inhibitor of the complement-fixation reaction associated with interferon treatment.


Osteosarcoma associated with metallic implants. Report of two cases in dogs. This is a report of two dogs in which osteosarcomas arose in association with metallic orthopedic implants. One neoplasm occurred in the distal humerus of a 12-year-old Doberman Pinscher. A stainless steel intramedullary pin had been implanted in the bone 11 years previously. Upon removal, corrosion of the pin was noted. The second neoplasm arose in the proximal tibia of a 12-year-old Irish Wolfhound. Six years previously, a fracture of the tibia had been repaired with a plate and screws made of the same type stainless steel, type 316L, by the same manufacturer. No corrosion appeared to have occured. Infection had not occured in either animal.


Growth characteristics of pulmonary metastases from osteosarcoma. Pulmonary metastases were measured in 7 patients with osteosarcoma. The growth curve of these metastases appears to conform closely to a Gompertzian function, a mathematical description widely accepted as a model for tumor growth in animal systems. Growth curves for pulmonary metastases were projected backwards assuming exponential growth for that period between amputation and initial roentgenologic detection. Lesion size at the time of amputation is estimated and found to vary widely from miniscule lesions of a few cells to large foci destined to become roentgenographically detectable within a few weeks of amputation.


Transforming factors in human sarcoma cells in tissue culture. Experimental data are presented which demomstrate the existence of a transmissible factor(s) in the majority of samples of leukemic bone marrow. This factor(s) is associated with the presence of a cytoplasmic antigen which can be detected by fixed immunofluorescence test with sera of patients with osteosarcoma, leukemia and some apparently normal individuals. Cultures of leukemic bone marrow carrying this factor(s) also form multinucleated cells when exposed to RD114 virus or cels. This factor(s) is transmitted into susceptible whole human embryo cells by cell-free culture fluid. Appearance of the new antigen can be detected by fixed immunofluorescence test about 6 weeks after transmission. Cultures showing the new antigen also form multinucleated cells following co-cultivation with RD114 virus or cells. Co-cultures of human osteosarcoma cells and leukemic bone marrow cells undergo morphologic as well as antigen changes after a long period of time (at least 3 months). Cell line fluids from these cultures contain a factor which induces in recipient whole human embryo cultures both the new antigen and morphological alterations resembling those observed in the co-cultures. Cell-free fluids from leukemic bone marrow and sarcoma cultures as well as from short-term co-cultures have failed to produce morphological alterations in whole human embryo cells. Extensive electron microscope studies carried out at different stages of the experiments have failed to reveal the presence of viral particles. The morphological changes resemble those induced in susceptible cells by sarcoma viruses. The described factor(s) may conceivably represent subviral components capable of biological activity. While suggestive of viral involvement in human sarcoma of bone and soft tissues, there is no definite proof of viruses being the causative agent(s) of human sarcoma. Present evidence provides only a basis for search of additional ways of treatment of human sarcoma to those of surgery and radiotherapy. Present treatment consists of chemotherapy as adjuvant treatment directed against viral markers represented by enzymes, nucleic acids and proteins of possible viral origin, resembling those already known to be present in animal bone and soft tissue sarcomas. However tenuous the contention of the possiblity of viral involvement in human osteosarcoma may appear, adjuvant therapy directed against viral markers warrants the attention of orthopedic surgeons and other clinicians.


Spontaneous pneumothorax and pulmonary malignant disease--a syndrome sometimes associated with cavitating tumours. Report of nine new cases, four with metastases and five with primary bronchial tumours. Tumours of the lung, primary or secondary, may occasionally be complicated by a pneumothorax, and on rare occasions this may be the presenting feature. Metastatic tumours associated with pneumothorax arise usually from bone or soft tissue sarcomas and hence are more common in the young.


Isolated intrapulmonary adenopathy in leukemia.


Dentists combine work and play in tropical vacation paradise.


Leukaemia in Nigerians: the chronic leukaemias.


Psychological aspects of white.

Psychological aspects of white. An attempt is made to answer the questions: Is white a color? How do we see fluorescent and non-fluorescent whites? What is the psychological and symbolic significance of white? A qualitative study was based on a sample of 1818 people from 24 differentiated groups from the age of 6 upwards. Two techniques were used in the enquiry: the well-known word association test, and a non-verbal method, new to psychology, which was devised specifically for the purpose of defining the psychological significance of white by emotional reference to a set of grey shades, a set of chromatic colors and a set of simple shapes. In a quantitative study, a sample of 1994 people were asked their reactions to fluorescent and non-fluorescent whites. This work was supplemented by linguistic investigations of the anthropological and physiological significance of white. The conclusion reached is that white meets a psychic need in man. Almost all the respondents attributed the characteristic of "whiteness" only to fluorescent whites.


Limits of accuracy obtainable in the direct determination by fluorimetry of fluorescent whitening agents on thin layer chromatograms. The quantitative direct determination of fluorescent whitening agents (FWAs) by thin layer chromatography involves limits of detection of 0.001 to 0.0005 mug. Visual assessment is about ten to a hundred times less sensitive than photometric measurement on thin layer chromatograms. The standard deviations in 10 measurements of two substances with different degrees of light sensitivity for a single measurement with a limit of detection of the order of 0.005 mug were about +/-13% to 44%. In the higher concentrations normally used (0.5 mug), the standard deviations were only +/-5% for both substances.


Comments on the isotope technique of determining fluorescent whitening agents. The notes on the specific marking of fluorescent whitening agents (FWAs) refer to publications in the literature and the example of an autoradiographic measurement of an 35S-labelled FWA of the 1,3-diphenyl-2-pyrazoline type.


Limits of accuracy obtainable in the direct determination by fluorimetry of fluorescent whitening agents in solution. In direct determination by fluorimetry the limits of detection are governed by the restricted light stability of fluorescent whitening agents (FWAs) in solution. The initial value of a fluorimetric reading can be registered by a rapid recorder, and in this way very light sensitive traces of FWAs as low as 10 parts per thousand million can be measured be measured with a statistical standard deviation of +/-15% for a single measurement and a reproducibility of +/-50% with a statistical certainty of 99%.


Direct determination of fluorescent whitening agents by absorption measurement in situ on thin layer chromatograms. The measuring technique for the chromatogram spectrophotometer (Zeiss) to determine the reflectance curves, the analysis according to the Kubelka-Munck function, and the basic outlines of the quantitative determination of stilbene fluorescent whitening agents (FWAs) are explained.


Analysis of river water and drinking water from seven European countries. During the months of June to August and September to December 1972 and again from January to April 1973, the river and drinking water at a number of points in seven European countries was examined for fluorescent content. The purpose of the river water studies was to identify any traces of fluorescent whitening agents (FWAs) and relate them as far as possible to knolementary role and also helped to interpret the scatter of the control level of the river water studies. Identification and separation were carried out by means of a combination of spectrofluorimetry and thin layer chromatography. Detection limits and reproducibility of the methods of determination are explained in the chapters V/3-7 (methods of analysis for FWAs. The second river water survey showed that at only one sampling point (Borås in Sweden) there was detectable concentrations (up to 8 ppb) of a lipophilic unsulfonated FWA [2, 5-BIS (BENZOXAZOL-2-YL)THIOPHENE], And these were still about 1 ppb in the third survey. JENSEN and co-worker had previously detected this substance at the same location. No traces of FWAs were detected in any of the other tests. The detection limit in river water was 0.01 ppb (1 part per American billion = 10(-3) gram per metric ton). For identification purposes, a test mixture of six FWAs each with a different chemical constitution and different fields of application was used, and this was first exposed to light in an aqueous solution for some minutes.


Bleed fastness of fluorescent whitening agents in mass whitened paper. Paper samples mass whitened with fluorescent whiteing agents (FWAs) of three different types (di-, tetra-, and hexasulfonated derivatives of 4,4'-diaminostilbene-2,2'-disulfonic acid) were examined for bleed fastness in five different eluents. Fluorescece intensity was measured by a sensitive spectrofluorimetric technique instead of the usual visual assessment. The degree of bleed obtained from each of the FWAs tested was less than 0.4mg/600 cm2 of paper surface area. The FWAs were applied at a normal concentration of use i.e. 0.05% active substance. FWAs with a high degree of sulfonation tend to bleed in aqueous solvents, and those with a lower degree of sulfonation in alcohol solutions. In aqueous acid solutions the degree of bleed was very low in all cases (0.04 mg/600 cm2 of paper surface area). In fatty solutions there was no bleed at all. The limit of detection was 3mug/600 cm2 of paper surface area, with an accuracy of +/-15%.


Measurement of the uptake of a 14C-labelled fluorescent whitening agent by fish from water and through a model food chain. A laboratory technique is described which simulates the uptake of a fluorescent whitening agent by fish directly from the water and indirectly through a model food chain. The use of radioactive labelled material enables the direct and indirect uptake and possible accumulation of the compounds to be measured quantitatively. The results are expressed as concentration factors. Between ecological and toxicological data a safety relationship is established.


Pilot trials with a fluorescent whitening agent of the bis(triazoly) stilbene-disulfonic acid type in golden orfes. Golden orfes were examined for uptake, distribution, and elimination of radioactivity administered in the form of a 14C-labelled fluorescent whitening agent (FWA) of the bis(triazolyl)stilbenedisulfonic acid type. Results of these studies are given below. Pilot trials using FWA concentrations of 10 and 100 ppb and a population density of 1 fish per liter show that an equilibrium between uptake and elimination of the FWA develops in the animals within a period of one week; i.e., the incorporated traces of the FWA are not irreversibly bound. The radioactivity is mainly located in the gall bladder and in the intestinal contents, as well as in the liver, throat, and gills. The muscular system (filet) is virtually free from activity. Approximately 1-2% of the FWA amount administered per animal (corresponding to the concentration factors of 7-14) can be temporarily detected in the fish. Radioactivity is eliminated comparatively quickly. Two days following the transfer of the fish into water free from FWA a concentration factor as low as 1 is reached, i.e. from this time the FWA concentration in the animals decreases to less than 10 resp. 100 ppb.